Large and Small Artery Compliance Changes During Hemodialysis
Heart disease is a major cause of morbidity/mortality in hemodialysis (HD) patients. Studies show changes in arterial compliance, independent of BP, predict mortality in HD. Changes in calcium which occur during the HD treatment may contribute to a reduction in arterial compliance during HD. Pulse wave analysis (PWA) via tonometry provides measures of large and small artery compliance. We used PWA to measure changes in compliance during HD treatment. PWA was recorded immediately prior to a HD treatment (Baseline) and midway through the treatment (Mid-dialysis). Large (C1) and small artery compliance (C2), systemic vascular resistance (SVR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Serum calcium was measured before and during the HD treatment. RESULTS: Six HD patients (3M/3F) whose mean age was 39 ± 17 years, weighing 151.0 ± 29 lbs and the mean height was 68 ± 4 inches were studied. The hemodynamic data is shown in table: all values are expressed as mean ± SD. The results showed a downward trend (C1), and a statisitcally sgnificant reduction (C2) in large and small artery compliance, respectively, with modest statistically insignificant changes in SBP and DBP. The SVR increase was of marginal significance. The calcium level rose significantly. We conclude that PWA detects changes in hemodynamics during HD not evident using conventional BP which may increase cardiac workload and contribute to the high cardiovascular morbidity and mortality in HD patients.